Last week, the United Nations Population Fund, released the 'State of World Population' report, a report that shone a light on the discrepancies in women’s reproductive rights around the world, Ireland included. We spoke with Dr. Natalia Kanem, Executive Director of UNFPA, to discuss the findings.

Firstly, a note on the woman herself. Dr. Kanem is an Ivy League graduate who began her varied career as a Pediatrician. Later, working in the field of Epidemiology, she studied "the course of HIV and AIDS" which led her to her first position in the UN where she worked as a representative of UNFPA in Tanzania. Over time, the physician worked her way up to executive director of the population fund, making her one of the highest-ranking women at the United Nations. 

Safe to say, she's the perfect woman to bring us through the stats.

Unfinished Business
Essentially, the report celebrates the key achievements that the UNFPA have made in the past 50 years, but it also calls for governments around the world to "finish the unfinished business". This year marks 25 years since the landmark International Conference on Population and Development (ICPD) in Cairo.

"Maternal mortality has come down by 40% over the past 25 years. However, there are still miles to go," says Dr. Kanem. "In particular, the report highlights the vulnerability that women and girls in the poorest, least developed, countries who still cannot get access to reproductive health, family planning, good maternity care." 

The UNFPA’s Nairobi Summit taking place in November will host governments, UN agencies, civil society, private sector organizations, women’s groups, and youth networks. Ideally, it will serve as the perfect opportunity for governments to build on the promises they made at the ICPD. 

"National legal systems have to be amended and activated in order to fulfill [their purpose], for example, on child marriage, female genital mutilation and things that prevent women in the world from legally accessing care."

Access and Education
Dr. Kanem named Ireland as a prime example of what happens when a country has access to quality education and family planning.

"In the past 50 years in Ireland, the standards of education and investment in women has really kicked off so, at this point, you don't have a big problem with teen pregnancy and that means that girls are finishing their education."

In contrast, when we look at countries like Niger in West Africa where fertility rates are 7.1 children per woman and 20% of the pregnancies are happening to girls under the age of 18, it's due to lack of access and gender imbalance.

"When you have a high rate of teen pregnancy, you have a high rate of death in childbirth and you have one of the highest illiteracy rates in the world," Dr. Kanem confirms. "What we're really talking about is equal rights as much as the health benefits."

Gender balance
According to the report, gender-based violence, child marriage, and fertility pressure are some of the biggest roadblocks to the UNFPA's work the world over. Gender-unequal norms remain among "the most significant drags on progress for women and girls" to freely make decisions regarding their health and rights.

Dr. Kanem explained that there are three gender-dependent aspects of relationships that are important in reproductive decisions: 

  1. The power of the individual
  2. The degree to which individuals are able to articulate and advocate for their needs
  3. The extent to which individuals have real choices.

"We surveyed 50 countries and noted that in these 50 countries, only half of the women were able - on their own agency - to decide whether or not to have sex, whether or not to go to the doctor or the nurse in the clinic and whether or not to avail themselves of family planning," she explains.

Husband school
The UNFPA works in more than 150 countries around the world, meaning that they have to work within numerous cultural norms, attitudes, and practices. For this reason, they have focused particular attention on faith-based communities and religious institutions. 

"No one wants to see a woman die while giving birth," says Dr. Kanem. "Therefore we try to engage respectfully with [these communities]. In Zambia, Niger, and Chad, we have seen literally thousands of Islamic scholars who now have said, very clearly, that family planning is good for families."

In Niger, which has the highest fertility rate in the world, the UNFPA is working with "husband schools" which work on the basis that men should be part of the solution. Men are "largely the decision makers" in the country and will decide whether to go to the clinic or not which is why it's so important that they understand women's health and family planning.

"It's so popular and so well-subscribed that now other countries are adopting that model. It has been amazing because when you introduce men to this information, they're pleased to be learning about their own bodies and the bodies of their wives. They're in a country of high illiteracy so nobody ever told them about these things so now it makes sense."

Ireland's involvement
On Friday, the Tánaiste and Minister for Foreign Affairs and Trade, Simon Coveney, announced Ireland's annual core funding contribution of €3.5m to the UNFPA in 2019.

"Ireland, on the world stage, is a big defender of women's health and rights," states Dr. Kanem. "But what we need to be looking at is organising all national health systems to define and deliver an essential package of high-quality services. It's one thing to say you have prenatal care, for example, but women will walk for hours to get there so what if the midwife isn't there that day?"

She continued: "Ireland has been very serious about the lives and choices for women in the least developed countries. That's been heartening because, on the world stage, Ireland speaks up. You defend women and girls."

To read the full report, click here.